PP is correct. Anyone that thinks these top-heavy companies lacking innovation can survive is fooling themselves. I suppose it is possible but Merck would have to look, act and be very different from the company it is today. A passion for research would have to return with a partnering with academics, and I don't mean the crap this company thinks is valuable right now (transitions of care B.S or those ridiculous trust and value scores. That is like comparing the bad to the worst). Pay for Performance is just like requiring signatures and equating those signatures with interactive value. Innovative products are what make a strong company.
There are more managers and middle managers at this company than anything I have ever seen. They need to go. Talk to any of your KOLs and they will tell you they want to do business with someone who has an advanced degree - one person not TEN! No HCP has time to see five reps, plus an MGAM, HSC, and Account Manager and Business Manager as well as your CTL and HQ! Our customers would be happy to order samples online as needed. Oh, and if they want actual MEDICAL information, they have to call for a PIR anyway. Customers want clinical information and research support and not under educated sales people detailing 10 and 12 year-old products.
Our customers have been saying this for years. They also do not want a "customer service" employee that cannot really help them with off-label questions in a real-time manner. Regulatory actually prevents it. What we see is more and more customers closing their doors. Now with the Sunshine Act, many have said "No" to lunch meetings and even more can no longer attend a sponsored dinner meeting or be industry consultants. This is where most new clinical information was exchanged. Some of the most important customers are no longer accessible. The decline of brands is also supported by our government that push generics as formulary choices. I realize CMS is the largest payer. Pricing as well as even research decisions are based on government trends, but this is like sleeping with the enemy. Older brand revenues continue to decline. Only companies first to market with a blockbuster or in a unique class will make money. As Merck scrambles to cut cost to pay their executives the big bucks, it cuts off its nose despite its face. This strategy will make the executives rich at the expense of all other lower employees and R&D.
Problem is the company will topple as new compounds will not be able to successfully launch with so little (and confusing) contact, support and cooperation from customer facing employees and the customers themselves. (Are we selling products or Pay for Performance services?) This industry sort of did to themselves. It is a strange situation where a few greedy companies and greedy customers have now hurt healthcare and the once valued industry to doctor relationships permanently. I do not think we can ever go back to the way it used to be and Merck needs to realize this. Medicine does not want to "partner" with us nor get their information from sales employees even if you call them customer service employees! We are not healthcare experts. We are a drug manufacturer! No one respects a medical company that has multi-million dollar executive leadership while it cuts all lower-level jobs, has little self-created innovation to R&D, raises drug prices and cannot seem to streamline its internal operations with true value and need. (How smart is it to cut R&D, do fewer clinical trials, fragment your customer facing employees and give your CRAs an overload?) In five to ten years, Merck will be half the size it is today. If it cannot create new compounds in a crowded marketplace, it will be just a marketing company and not a science organization. (Does BMS ring a bell?) Then the split with academic medicine will be complete, contacts severed and relationships over. The company will fail.
America needs innovative products to sell not more unnecessary and self-created services from middle management. An example: I love the peer discussion groups and so do my doctors but I doubt these programs "sell" that much more product. Granted, they are better than a canned lecture. They hold an already strained relationship barely together with a few thought leaders. How much better if years ago, Merck and all its acquired companies had listened to the customer on RESEARCH initiatives. Companies that are going through tough times and might be merged or acquired, do little research and even less grant support. Relationships shuffle and get destroyed. Good people leave. By the time the ink is dry, the clock has ticked and patents are running out. The acquired branded compounds lose money; the acquired pipeline products are never as promising as they appeared on paper, and Merck (like the other giants) only has plans to acquire another company or compound in the same position. It is instant gratification with no way out as long as the goal is for the executive team to look good to the stockholders. Everyone seems to discount the extreme cost of reorganization.
At the core of the problem is a total failure from executives and marketing to understand what it really takes to create an innovative medical product and how to grow a science-based business long term in such a mature market, or how to appropriately interact with academic medicine and have these products be affordable, timely and clinically valuable. The patent clock ticks and Merck is throwing darts at a wall hoping something sticks.
I will say the most valuable players/liaisons at Merck now are the HSCs. Customers seem genuinely excited to exchange scientific knowledge and perhaps gain research support. However, a word of caution, most customers want to be published and want OUR money. There is still a disconnect with what compounds will financially support a big company and be important to the future of patient care. Patents will run out before Merck can recoop her costs or figure it all out (same with the other big drug companies). The research enterprise as a whole has serious organizational issues including the discovery and selection process. This is where investments needed to be made in order for these big drug companies to survive. Good luck, Merck and the rest of big pharma; you will need it since lawyers and not scientists are in charge, and their communication gap is as wide as the Grand Canyon.
A good medical sales person with the proper degree and resources can sell a product as long as it is truly valued and needed. You can polish a turd but it's still a turd. I have a cloth in my company car.
